Most every day by 5 PM, I have a host of residents wanting to go home.Some call out for “mama”, some look for the bus out of the window, others try to find a way out because they must get home “before dark”. We redirect them, while yet validating that the bus is coming, mama is coming and assure others we will get home after the bad storm passes. We know the root of this “behavior” is related to the progression of the disease process and discard any other possibility. We contribute their “Sundowning” to variables such as: end of day fatigue,reduced lighting that increases shadows creating confusion and hallucinations (common objects look different when it is darker). We also consider Circadian cycle (sleep/wake patterns) that can be damaged as a result of Alzheimer’s disease and other disorders—the person cannot distinguish day from night. If none of those really apply to the resident, then we just define their behavior as a lack of activity in the afternoon compared to the morning activities. By 5 PM, the activity staff have left for the day,the extra bodies (housekeepers, dietary aides, administrative personnel) have punched out and gone home. New faces have appeared in the facility, talking about dinner time, bath time and shower time. Why wouldn’t the dementia patient think it was time to go home as well? They too, wish to go home to their loved ones and family. Never underestimate a dementia patient’s ability to recall past memories that seem to them as if they are occurring in the present moment.
“I have to go home to Raymond”. Raymond has been deceased for over 20 years, but to this resident, Raymond is alive and well. She can tell you everything you want to know about him including what she is making for supper for him.
“He never did eat vegetables. Well, he did like potatoes. I guess I will make potatoes.”
Memories. She can remember potatoes, but not recognize her own daughter. She can tell you about her house in Tennessee, located on Grove Street. If you ask her what state is currently in, she will reply, “Tennessee”. She and Raymond lived in Tennessee together for 50 years. Each day at 5 PM, she is ready to go home and take care of Raymond, and “fix supper”.
Scientists have long studied and debated where memories are stored in the brain. Some say it’s this, others say it’s that….truth be told, they do not know. It is similar to searching for the soul in the body. Memories can not be seen, only shared and relived.
The other night I was sitting outside looking at the bright array of stars. I noticed a pattern, that appeared to be an outline of a dog. I could see the definition of ears, nose and neck. It looked just like my Jack Russell, Annabelle, who had shared her life with me for over 15 years. Memories came flooding back of her chasing the Fed Ex truck down the street. I could hear her barking at the neighbors plastic Christmas deer in their yard. I remembered when she was 6 months old, how she played with a copperhead, dancing, jumping and playing with the not- so- friendly snake, Silly puppy. The memories that flooded my thought processes were all wonderful antics of my beloved Annabelle. Not once did the bad memory of sitting in the vet’s office at 11 PM, on March 21,2012 come to mind. The simple line up of the stars and clouds allowed my brain to retrieve those happy memories. It is not different than the memories a dementia resident relives. Getting home to Raymond is no different than my seeing Annabelle in the sky. The memories stored in our brains are there to be cherished, revisited and relived. The only difference is the ability to recognize and accept the time differences of past and present.
Researchers will continue studying the hippocampus region of the brain, Npas4 (the gene that controls the formation of memories) and the interactions of neurons. They will one day, maybe,just maybe, be able to identify our memory maker and find our storage units, but until then we need to be understanding of our geriatric population. They too have memories. They too have loved someone that they miss today. They have a house that they lived in for 50 years that was “home”.
Each day as we all go about our lives, we are creating future memories. When I am 99 years old, living in a nursing home, I know the staff will think I am crazy.
“Annabelle, come here girl, come on Annabelle….let’s go for a walk….come on girl….”